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14652 (PLBG)No. x.4652 ' --- •. >;� !' P.O. BOX 1504 Building Address 51-"`986 Ave. J*aarez LA QUINTA, CALIFORNIA 92253 - Owner_ Albion iT! nkiilss Mailing Same BUILDING: TYPE CONST:' •OCC. GRP. Address A.P. Number . City Zip TTe La. Quinta., .CA 92253 Legal Description Contractor Project Description _ Sever Connect Preferred -'Plumbing Address P.O. Box 6178 ?91M TeJ.' - bre, 92263 322-3173 State Lic. City & Classif.`.: Lic. # Sq. Ft. No. No. Dw. Arch:; Engr., Size Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby aff 70hat I am licensed under provisions of Chapter 9 (commencing with Section - 7000) of Division 3 of the Business:and $rofe'ssions Code, and my license sin full force and eft ct ,1 61GNATURE ./' ti. ) r '�"" - DATE , 1 OWNER -BUILDER DECLARATIONA I hereby affirm that I am exempt from the Contractor's License Law for the following , . Estimated Valuation .reason:,(Sec. 7031.5,Business and Professions Code:,Any. city .or county .which requires a permit to construct, after, improve, .demolish, or repair any structure,. prior to its issuance also • ' AMOUNT requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT the provisions o/ the Contractor's License Law, • Chapter' 9. (commencing with Section 7000),of ' DWslon 3 of the Business and Professions Code, of that. he is .exempt therefrom, and the basis for the alleged- exemption. Any violation of Section 7031.5 by 'any applicant for a permit. 'Plan Chk. Dep. subjects the applicant to a civil penalty of not more than rive hundred dollars ($500).P O I, as.owner of the property, or my, employees with wages as their sole compensation, will. Plan Chk. Bal. do the work, and the structure is not Intended or offered for sale. (Sec.. 7044, Bulsness and Const. Professions Code: The Contractor's License Law does,.not apply to an owner of property who, builds or improves thereon and who does such work himself or through his own employees, .Meth. provided that such improvements are not intended or offered for sale. If, however, the building or improvement is said within one year of completion, the owner -builder will have the burden - - Electrical . of proving that he did not build or improve for the purpose of sale.) O'1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 3t �� struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an, owner of property who builds or ,improves thereon, and who contracts for. S.M.1• such projects with a contractors) (Tcensed pursuant to the Contractor's License Law.) - Grading O I am exempt under Sec. B. 8 P.C: for this reason Driveway Enc. Dateowner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby afffrrm that I have a certificate of consent to self -insure, or a certificate of Worker's sensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code:) Pohicy0 Company �1-Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL 36.40 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) ' I certify that in the performance of the work for which this -permit is issued, 1 shall -not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California Date Owner NOTICE TO APPLICANT: N, after making this -Certificate o/ Exemption* you should become : ZONE: BY: subject to the Workers' Compensation provisions o/ the, Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. - ' Minimum Setback Distances: - - Front Setback from Center Line I Rear Setback from, Rear Prop. Line WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND' Side Street Setback from Center Line SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES -UP TO.ONE HUNDRED.THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Side Setback from Property Line i DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. f ; This is a building- permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR expiration it work thereunder is suspended for 180 days. i I certify that I have read this application and state that.the above information is correct. Issued by: Date I Permit I agree to comply with all city•and county ordinances and state laws relating to building i construction, and hereby authorize representatives of this city to enter -the above-. mentioned property for inspection purposes. Validated by: Signature of applicant Date i'• I� Mailing Address Validation: City, State, Zip .. - . rte. CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES v IST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SO. FT. ® - CAR P. SO. FT. WALL SQ. FT. ® SO. FT. ® .ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN_ URINAL WATER PIPING NOTE: Not to be used as property tax valuation ROUGH PLUMB. FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAS (ROUGH) LAUNDRYTRAY AIR HANDLING UNIT CFM HEATING (FINAL) KITCHEN SINK ABSORPTION SYSTEM • B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER, B.T.U. SO. FT. ® c BATH TUB BOND BEAM SQ. FT. ® c WATER HEATER MAX, HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11A c SEWAGE DISPOSAL LUMBER GR. SQ.FT.GAR ® 3/ac HOUSE SEWER FRAMING FINAL INSP. i3� s - GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO, FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING - ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER`OR SEP S ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL ' GAS (FINAL) TEMP. POLE GROUT WATER HEATER. SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. i3� s - ROOFING REMARKS: VENTILATION FIREZONE ROOFING: FIREPLACE.. SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL ' INSPECTOR'S SIONATURESlINITIALS - GARDEN WALL FINAL- -• COACHELLA VALLEY WATER DISTRICT .. CASH RECEIPT DETAIL N2 s 9 S 99 Received From:: oj�:t--5— 1i �I'L-4r: / n/ z . Address: - Account No. 4 Lof(s) Service Address -�� 9(ttn AUS• ��1.(A 229Z- ❑ Meter(s) ❑ Service(s) ❑ Backflow(s) ❑ House Lateral(s) ❑ DetectorCheck(s) ❑ Meter.Surcharge C anitation Capacity Charge ❑ W.S.B.F.C. ❑ Temporary Construction Meter ❑ Turn on Charge ❑ Uncollected Account - Name ❑ Inspection Fee - Tract - Fee - ❑ Plan Check Fees Water I Sewer - Tract - ❑ Bond Payment - A.D. - Bond ❑ Customer ❑ Other_ i i_ Tract Si JR1G 7- G.A. Code a t B O I �� TOTAL a / • Remarks: C'u570ni T 2 t.U(L L MAIL AALIZ r+ 1 ❑CoPyto:l AfZ :a cr Cash Water Service Check 011 551 .L•r. ' -;' / Cashier Money 0rder y� ( CVWD-6361111891 W V Z :1. SANCO� Q PUMPING SERVICE' q y' ®, "'_ 2 Morongo Trail 63 prings, CA 92264 619)327-8859 ` 619) 327-8859 SOLD TO - ~� �' ,�'' SNIPPED TO ATE , STREET NO. STATE STREET NO. s/ 1p l�C.-tJ vGzC .aaL �7 a�✓Ylr C�Y.3�-�. �[� er CITY ji STATE%" ZIP CITY STATE ZIP , CUSTOMER ORDER S LESMAN TERMS ATE , / Q� vGzC .aaL �7 a�✓Ylr C�Y.3�-�. �[� er r U!' 0 , PAYMENT DUE UPON RECEIPT